Sunday, March 22, 2009

It seems that ADD-ADHD is becoming epidemic. Why are so many more children being diagnosed with this problem today? The following may give a few answers.

Deficiencies and problems often found in ADD-ADHD:1. Deficiencies in nutritional value from food. The diet many children eat today contains chemicals unknown to the human body and lack nutritional value. Many of these chemicals can affect our brains in a negative way. For example, Feingold hypothesized and did many studies showing that artificial colors and flavorings dramatically increased ADD-ADHD symptoms in those with that propensity. Eliminating processed foods, artificial flavorings, colorings, preservatives, and sugars have been shown to help the hyperactivity aspect of the affliction.

Many children are not introduced to or fed adequate fruits and vegetables to improve their nutrition. When they are used to eating the prepared foods with chemicals and sugars to make them taste better, the natural foods don't taste good to them. When they do get natural foods, often these foods are do not have adequate nutrient value because of the soil depletion.

The deficiencies found in the modern diet have a profound effect on the health of the brain. These deficiencies which have been found in many ADD-ADHD children include:

Tryptophan, an amino acid which is a precursor to serotonin and melatonin.

Zinc, necessary for the function of many enzymes, required to make fatty acids and immune system function, deficiencies can add to mood disorders.

Tyrosine, an amino acid which helps make dopamine and norepinephrine, and is needed for the thyroid hormone.

Magnesium, necessary for the function of many enzymes. Depleted when eating too much sugar or over-stressed. Deficiency of magnesium causes the muscles and body to be hyper-excitable.

Omega 3 and GLA fatty acids, because of the high levels of trans fatty acids (man-made fats that are unable to be used in the body and cause oxidation and inflammation, including in the brain) in todays diets, especially in processed and snack foods, the excess trans fats in the body also cause a deficiency of omega 3 fatty acids, which include EPA and DHA, and an omega 6 fatty acid called GLA, all very necessary for brain and for cellular function. It has been shown that a majority of ADD-ADHD children have excessive trans fats in their cells.

Iron, necessary for adequate oxygen to the brain, as well as the executive centers in the brain. If iron is low, it affects learning and behavior. (Check with your doctor to see if iron is marginally low, as too much iron will also cause problems.)

Good, clean water—few children like to drink water any more. They drink juice, sodas, artificially flavored and colored drinks, sweet drinks, etc., which do not increase the fluid levels in the body, and sometimes are actually dehydrating. Most children are marginally dehydrated. If the brain is only 5% dehydrated, brain performance will drop remarkably, and they will feel fatigued.

2. Deficiencies or imbalances of Neurotransmitters. This is often because of the lack of the nutrients above. Neurotransmitters are molecules in the body that transmit signals between nerves. There are many kinds, each having a different purpose. They each have their own receptors on the nerve endings that, when attached, tell the nerve what to do. Some tell the nerve to send signals, some tell the nerve to stop sending signals.

In ADD-ADHD, there are often deficiencies in some or all of the following neurotransmitters:

Dopamine. This neurotransmitter is very important. It is the lack of dopamine that causes Parkinson's Disease. The deficiencies in ADD-ADHD are not as severe as in Parkinson's, but there are still problems. It is hard to pay attention, to focus and concentrate, and there seems to be a lack of caring and difficulty loving and connecting to others.

Endorphins (natural opioids). These allow us to feel good and reduce pain. A lack causes a sense of urgency, a need to hurry, and an increased sensitivity to pain.

GABA (Gamma amino butyric acid). This is a neurotransmitter that tells the brain to calm down and stops signals. A deficiency often results in a feeling of anxiety.

Norepinephrine. This causes a release of adrenaline, and in many causes a good “rush” feeling. Many with ADD-ADHD become “adrenalin” junkies, seeking thrills to increase the feeling from this neurotransmitter.

Serotonin. This allows a feeling of well being and enables sleep. The lack may increase depression symptoms and cause difficulty sleeping.

A good amino acid and vitamin supplement to assist the body in creating the needed transmitters is often useful. Also, changing the brainwave patterns through neurofeedback will often assist in balancing the neurotransmitters.

3. An excess of neurotoxins in the food and environment. Many of the chemicals in our food and environment are neurotoxins, meaning they are toxic to our nerve/brain cells. The chemicals in the food used as preservatives, colorings, flavorings, fillers, and artificial sweeteners (especially aspartame--Nutrasweet and Equal) are unknown to the human body and can have neurotoxic effects.

Our water supply is not immune to these pollutants. The soil which our food is grown in is becoming more polluted. Industry is spewing forth heavy metals. Mercury is found in our teeth, fish and immunizations. Lead poisoning is still a problem for both children and adults because of old paint, old pipes, industrial pollutants, etc.

Children born to mothers exposed to pesticide spraying in farming communities have a much higher incidence of autism and other brain problems. Pesticides are in our food supply and the spraying of lawns and houses magnifies the problem. Pesticides are neurotoxins and children eating a normal diet compared to children eating an organic diet were shown to have up to 20 times more pesticides in their urine. A single apple can deliver an unsafe dose of organophosphates to a child.

The foods most contaminated by pesticides, according to the FDA, are US-grown strawberries, apples, and peaches, and Mexican-grown cantaloupe. These should be only consumed if they are organic. You can dramatically reduce the exposure by peeling the apple and peach, though there are still pesticides in the fruit itself.

The fruits and vegetable which are least contaminated are US-grown cantaloupe, watermelon, bananas, kiwi, pineapple, peas, corn and onions.

Exposure to electomagnetic frequencies (EMF) is increasing both inside and outside of our homes. Children who live near high powered electrical lines or microwave towers have been shown to have a higher incidence of cancers, especially leukemias. Some people are “sensitive” neurologically to EMF, and their problems are aggravated by televisions, microwave ovens, computers, cell phones, etc. There are products that can reduce the effects of EMF on people.

Next visit we will talk about treatments and possible alternatives to medication.

Anxiety—sometimes when a child or adult is suffering from anxiety they have trouble staying still and focusing. ADHD medication will make this problem worse. A QEEG can often determine if the medication will work or not.

Learning disabilities—if a child is having problems learning, they will often exhibit poor behavior. School becomes difficult and they start losing attention. Many children labeled as having ADD-ADHD actually have learning disabilities.

Hearing and vision problems—an undiagnosed hearing or vision problem can cause similar problems to learning disabilities.

Hyper- or hypothyroid—the thyroid affects the metabolism and an imbalance in the thyroid can mimic ADD-ADHD in a child.

Elevated toxins—such as lead. There is still a high amount of lead poisoning in children. Other toxins such as mercury in teeth, environment and immunizations, and chemicals in food and air can have an affect on their brain function.

Poor parenting skills—we hesitate to blame parents for behavioral problems, as ADD-ADHD is very difficult for parents to live with and deal with. However, if a parent has not been taught good parenting skills by their own parents, they may be unaware that their way of treating their child may be increasing misbehavior by that child. Most of us can become better parents and help our children by learning better parenting skills.

If you or your child have one or more of these problems, medication will only cover the problem and sometimes not help. Even if you or your child has ADD, these problems will make the ADD worse. It's important to discover if these are part of the problem. Some of them will only be found by a more integrative physician, utilizing both regular Western medicine and alternative/complementary medicine, specialized optometrists (for vision problems), and specialists in learning disorders.

The next blog we'll discuss some of the deficiencies found in people with ADD-ADHD.

Sunday, March 1, 2009

Cameron is a sweet, darling boy, who has been suspended from kindergarten and first grade more times than you can believe such a young child could. Cameron suffers from Attention Deficit/Hyperactivity Disorder. It causes impulsive behavior that causes him to do things without thinking of the consequenses. The consequences are that he gets suspended from school.

Attention Deficit Disorder is a biologically based condition causing a persistent pattern of difficulties resulting in one or more of the the following behaviors:

inattention

hyperactivity

impulsivity

Attention Deficit/Hyperactivity Disorder is the name often given when ADD also includes hyperactivity and impulsive behavior.

This definition and the symptoms are very ambiguous. These symptoms can describe most children, especially in their younger years. So the diagnosis is not usually made until a child is seven to nine years old.

ADD is not generally something that is “grown out of.” Children with ADD generally become adults with ADD. It is still difficult to deal with as an adult, but often they do learn how to make adjustments for their disabilities to get on with life.

Diagnosis of ADD-ADHDThere is no conclusive test to prove a child/adult has ADD-ADHD. It is a psychiatric diagnosis based on reported behavior by parents, teachers and self. There are no specific physical signs or symptoms. The behaviors vary in severity and symptoms. It is often difficult to accurately establish. The diagnosis of ADD-ADHD is determined by the clinician, based on the number, severity and duration of symptoms and the degree of impairment in daily activities.

The following are common symptoms of ADD-ADHD:

Has difficulty sustaining attention in tasks or play activities.

Is often easily distracted by outside stimuli.

Often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities.

Often does not seem to listen when directly spoken to

Is often forgetful in daily assignments and activities

Often fails to finish activities started, such as homework, schoolwork, chores, or duties at work.

Often has difficulty following through with instructions.

Often has difficulty organizing tasks and activities.

Often loses things necessary for tasks.

Often avoids or has difficulty completing tasks that require sustained mental effort.

The following are common symptoms of hyperactivity:

Finds it hard to be still—fidgets with hands and feet and squirms in seat.

Often leaves seat where sitting is expected.

Moves around, runs and climbs inappropriately.

Often has difficulty playing quietly.

Often talks excessively.

The following are common symptoms of impulsivity:

Does not give others time to speak; often blurts out answers before the question is out.

Has difficulty waiting their turn.

Often intrudes on others; has little sense of another's personal space.

Acts on what he/she wants in the moment without considering the consequences.

Does not seem to learn from negative consequences.

Though brain scans are not done for diagnosis, it has been shown that children/adults with these symptoms have brain changes. Both functional MRIs and Quantitative Electroencephalograms (QEEGs) show that there is under-activity and slower brain wave activity in the frontal cortex of the brain. These areas are often smaller than that of a normal child's brain of the same age.

These scans are not used for diagnosis, but they can be used to monitor treatment.The brainwaves produced when we are awake and alert are beta waves, which are fast, high voltage type waves. People with symptoms of ADD-ADHD often have excessive slow, low-voltage type waves called theta waves, which are common in the drowsy and daydreaming state. That is why they have trouble focusing and concentrating, and why stimulant drugs help their symptoms, because they speed up the brainwaves.

The pre-frontal cortex is involved with voluntary control of attention, the inhibition of inappropriate and/or unwanted behavior, the planning of actions, executive decision making, maintenance of arousal (or the awake and alert state), and the sequencing of complex activities. When the pre-frontal cortex isn't as active, there will be problems with inattention, poor impulse control, difficulty planning ahead and completing tasks, poor decision making, daydreaming and poor focus, and difficulty carrying out instructions.

At Vanguard Center for Neurological Medicine, we do QEEGs to determine if these problems are present in the brainwave patterns of people with ADD-ADHD symptoms. See http://www.vanguardbiofeedback.com/.

In the next blog we'll talk about other problems that could cause symptoms similar to ADD-ADHD, and deficiencies often found in the ADD-ADHD population.

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